PubMed Health⌕ Search

Biomedical subjects

S Ariad

Publications and source records attributed to S Ariad.

At least 37 records · Page 2Linked to original sources

Apoptotic index as a prognostic factor in Hodgkin's disease.

Hodgkin's disease (HD) is an unusual malignant neoplasm, mainly because of the rarity of tumor cells in the diseased tissues, but also due to a relatively favorable response to treatment. In a previous study, we have shown a variable degree of apoptosis in lymph nodes from HD patients. We now looked for clinicopathological correlations of apoptosis with special emphasis on the prognosis in this disease. A retrospective study of 92 patients was carried out, using in situ end labelling of DNA fragments and an apoptosis detection kit. An apoptotic index (Al) was calculated in each case, as the percentage of apoptotic Hodgkin-Reed-Sternberg cells out of the total number of tumor cells in 10 selected high power fields. An association between a high Al and advanced stages was noted. A Kaplan-Meier analysis showed a negative correlation between Al and survival (p=0.05). In a multivariable analysis adjusting for Ann Arbor stage, a high Al carried a 3.27 fold risk of dying of HD (OR=3.27; Cl=0.89-11.94). However, in our limited cohort of HD patients, Al was not an independent prognostic factor. The results of this study confirm the important role played by apoptosis in HD and suggest that the apoptotic index is probably a negative prognostic marker in this disease. Its assessment in patients with HD may provide a new, important clinical tool.

Adult↗

[Mixed uterine mesodermal sarcoma in the population of southern Israel in the years 1996-1971--clinical and pathological characteristics].

During 1971-1996, 17 patients with mixed mesodermal uterine tumors were treated. Average age at diagnosis was 67.3 years, 12/17 were of European and 5/17 of Afro-Asian extraction. The overall 5-year survival was 21%. 10/17 patients had mixed mesodermal tumors with a heterologous mesenchymal element, and 7/17 had a homologous mesenchymal element (carcinosarcoma). 6/17 had another primary malignancy, including breast cancer (3/17), bilateral metachronous breast tumor (2/17), and malignant lymphoma of the neck region (2/17). All 3 with breast cancer had previously been treated with tamoxifen. I had simultaneous mesodermal tumor and ovarian thecoma. Simultaneous autoimmune manifestations occurred in 2/17, including thrombocytopenic purpura in 1, and myasthenia gravis in another. Mesodermal tumor of the uterus is a relatively rare malignancy with aggressive behavior and poor prognosis. It also had unusual associations with other primary tumors, hormonal treatment, and autoimmune manifestations.

Aged↗

Malignant melanoma metastatic to the ovary.

The diagnosis of malignant melanoma metastatic to the ovary is rarely made in living patients. A case of malignant melanoma metastatic to one ovary, skin of both axillae, and brain occurring 7 years after wide local excision of the primary cutaneous lesion on the patient's back is described. The patient had total abdominal hysterectomy, bilateral salpingo-oophorectomy, infracolic omentectomy, and selective pelvic retroperitoneal lymphadenectomy, followed by whole brain irradiation and chemoimmunotherapy. This case illustrates the clinical variability and unpredictable biologic behavior of malignant melanoma and it is concluded that malignant melanoma metastatic to the ovary should be suspected in any patient who presents with an adnexal mass and has a history of malignant melanoma.

Axilla↗

Severe, diffuse osteosclerosis: A new manifestation of transitional cell carcinoma of the urinary bladder.

A 56 year-old man with a 2-year history of transitional-cell carcinoma of the urinary bladder presented with back pain and diffuse radiological osteosclerosis. Laboratory studies revealed borderline-low ionized serum calcium, and markedly elevated serum alkaline phosphatase (ALP) activity and serum osteocalcin. Serum acid phosphatase and prostatic-specific antigen (PSA) were normal. Serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were just below the normal limit and parathyroid hormone was moderately elevated. A transiliac bone biopsy specimen revealed expanded bone trabeculae, abundance of osteoid-covered surfaces, and heavy metastatic spread. To the best of our knowledge, this is the first description of the association of osteosclerosis and metastatic transitional-cell carcinoma of the bladder.

Bone and Bones↗

Metastatic angiosarcoma of the spleen after accidental radiation exposure: a case report.

Angiosarcoma is a rare malignant tumor arising from endothelial cells of blood vessels or lymphatic channels. Therapeutic irradiation, thoriumdioxide administration, pyothorax, and polyvinyl chloride exposure have been shown to be predisposing factors for developing angiosarcoma. Accidental radiation exposure has not been associated with angiosarcoma. We present an unusual case of angiosarcoma of the spleen, with metastases to bone, liver, breast, and bone marrow, in a woman who lived near the Chernobyl nuclear facility in the former Soviet Union at the time of the reactor accident in 1986. To the best of our knowledge, this is the first report of metastatic angiosarcoma after accidental radiation exposure.

Female↗

Association of the Epstein-Barr virus with Hodgkin's disease in Southern Israel.

Epstein-Barr virus (EBV) has been frequently documented in the putative neoplastic Hodgkin-Reed-Sternberg (HRS) cells, in lymph nodes from patients with Hodgkin's disease (HD). This association varies in different geographic areas and between industrialized and developing countries, as does the epidemiological pattern of the disease. In the present study of 106 cases of HD from the Soroka Medical Center in Beer-Sheva, which serves as the only hospital for most of the southern part of Israel, we found an association with EBV expression in only 30% of the patients; 45% of mixed cellularity (MC) cases compared with 21% of nodular sclerosis (NS) cases were positive for EBV. The number of patients in the 0-14-year-old age group was limited; however, 8 of these II children were EBV positive. This low association rate of HD with the presence of EBV sequences is probably related to the small number of children in our series. A low proportion of EBV-associated disease in older adults may be contributory. Other factors may be involved.

Adolescent↗

Myasthenia gravis associated with malignant mixed Mullerian tumor of the uterus.

Myasthenia gravis is a neurologic disorder characterized by intermittent muscle weakness which improves after anticholinesterase medication. The pathogenesis of myasthenia gravis is associated with production of autoantibodies to nicotinic acetylcholine receptor in the motor end plate. Most patients do not have an underlying neoplasm, but in 10-15% of the cases, a thymoma may be detected. Apart from thymoma, no other tumor type or organ has consistently been associated with myasthenia gravis. We describe an unusual case of myasthenia gravis in a patient with malignant mixed Mullerian tumor of the uterine corpus. Initial histology revealed malignant mixed Mullerian tumor of a predominant carcinomatous element. At that time, there were no symptoms of muscle weakness. Intraabdominal metastases were detected later, concommitantly with symptoms of muscle weakness and the diagnosis of myasthenia gravis. Histology of the metastases disclosed an exclusive mesenchymal element with striated muscle differentiation. To the best of our knowledge this case is the first report of myasthenia gravis in a patient with malignant mixed Mullerian tumor of the uterine corpus. We propose that the mechanism contributing to myasthenia gravis in this patient was closely associated with the evolving histology and with the nature of the tumor, so that antibodies produced to muscle-like epitopes exposed by malignant cells could have cross-reacted with acetylcholine nicotinic receptors and caused myasthenia gravis.

Female↗

Gluteal manifestation of advanced Hodgkin's disease.

Hodgkin's disease (HD) is a nodal malignancy with a characteristically axial pattern of spread and with contiguous progression via lymphatic channels. Even when dissemination occurs beyond the lymphoreticular system, certain patterns of associated spread are frequently evident. We describe a case of nodular sclerosis HD with a 12-year indolent course and late involvement of the gluteal muscle. Initially, stage was IVb with spleen and bone marrow involvement, complicated by a Coomb's positive hemolytic anemia. Following chemotherapy, the patient had a partial response with the subsequent long course of slowly progressive disease invading first the urinary bladder and, later, the gluteus. Involvement of the gluteal muscle is a rare event in HD. Spread to the gluteus occurred most likely by contiguity, via retroperitoneal lymph nodes.

Antineoplastic Combined Chemotherapy Protocols↗

Granulocytic sarcoma of the chest wall at site of Hickman catheter tract.

Insertion of a Hickman central venous catheter before administration of induction chemotherapy is a common practice in treatment of patients with acute myeloblastic leukemia (AML). Granulocytic sarcoma associated with AML may be the initial clinical manifestation of newly diagnosed or relapsed AML, heralding systemic involvement by weeks to months. A case of granulocytic sarcoma of the chest wall occurring as subcutaneous nodules along a scar of a previous Hickman catheter tract in a 45 year old female patient with AML is described. The patient who was in first complete remission, developed granulocytic sarcoma simultaneously with complaints associated with leukemic CNS infiltration. This is the second case described of granulocytic sarcoma of the chest wall at the site of a Hickman catheter tract. The simultaneous CNS and chest wall manifestations raise the interesting question whether both sites behaved as sanctuaries for resistant leukemic cells, in this case.

Antineoplastic Agents↗

Breast lymphoma. A clinical and pathological review and 10-year treatment results.

Sixteen patients presenting with lymphoma involving the breast are described. Seven fulfilled the criteria for primary breast lymphoma, while the other 9 had evidence (sometimes only detected after extensive staging procedures) of concurrent lymphomatous involvement outside the breast. Histological diagnoses of the so-called primary breast lymphomas included 1 case of Hodgkin's disease and 6 of non-Hodgkin's lymphoma (including 2 with T-cell phenotypes). The patients with so-called secondary breast involvement included 8 with non-Hodgkin's lymphoma and 1 with a plasmacytoma of the breast with concomitant myelomatous involvement of bone marrow. Among the non-Hodgkin's lymphomas involving the breast the whole range of histological subtypes from low-grade to high-grade lesions were seen. There was no subtype of lymphoma with a specific predilection for breast involvement. Expression of oestrogen receptor protein as determined by immunocytochemical investigation using specific monoclonal antibodies was uniformly negative in lymphoid cells of 11 patients studied. Most of the patients in this series were treated by chemotherapy with uniformly good local control of lymphomatous involvement of the breast and an outcome similar to that of lymphomas presenting at other body sites. It is concluded that the approach to lymphomas of the breast should be similar to that of the equivalent types presenting elsewhere.

Adult↗

Lack of involvement of T-lymphocytes in the leukaemic population during prolonged chronic phase of Philadelphia chromosome positive chronic myeloid leukaemia.

Nine patients with prolonged (> 2 years) chronic phase chronic myeloid leukaemia (CML) were investigated for the presence of T-cell involvement in the leukemic clone. Pure populations of peripheral blood T-cell populations were obtained by culturing separated mononuclear cells in the presence of pokeweed mitogen and IL2, until cultures showed > 99% pure T-cells. Purified T-cells and bone marrow and peripheral blood hematopoietic precursors were analysed for the presence of bcr-abl mRNA transcripts following RNA extraction and message amplification using polymerase chain reaction. In none of the 9 patients was bcr-abl mRNA found in T-lymphocytes while in all cases such transcripts were found in bone marrow and peripheral blood hematopoietic cells. Failure to detect T-cell involvement in patients with prolonged chronic phase CML using techniques designed to enhance even low level involvement of these cell populations supports the view that acquisition of the Ph chromosome abnormality does not occur in the totipotent stem cells but in more committed precursor cell/s with multilineage capacity but which only rarely retain the capacity for T-cell differentiation.

Biomarkers, Tumor↗

NOPE for relapsed aggressive diffuse non-Hodgkin's lymphoma.

Forty three patients with relapsed, diffuse aggressive lymphoma (Working Formulation Categories G to J) were treated with a combination chemotherapy regimen consisting of mitoxantrone 10 mg/m2 iv day 1, vincristine 1.4 mg/m2 iv day 1 and 14, prednisolone 50 mg/m2 p.o. days 1-5 and etoposide 100 mg/m2 p.o. days 1-5 of each cycle (NOPE). Fourteen patients (34%) achieved complete remission and another 6/43 (15%) achieved a partial response. Factors which significantly affected response were the presence of early stage, absence of systemic symptoms, non-bulky disease and serum LDH value < 350 IU. Four patients are alive and in complete remission from 25+ to 45+ months after completion of therapy. Duration of response and survival was significantly influenced by the duration of the initial response to first chemotherapy. NOPE is an active and safe treatment regimen with a substantial complete remission rate in patients with relapsed non-Hodgkin's lymphoma.

Antineoplastic Combined Chemotherapy Protocols↗

Kaposi's sarcoma after alpha-interferon treatment for HIV-negative T-cell lymphoma.

A 54-year-old HIV-negative patient suffering from T-cell lymphoma of Lennert's lymphoma (Lel) type was treated for 13 months with interferon alpha-2b. While on treatment with interferon the patient demonstrated suppression of total and CD4+ lymphocytes to levels < 0,5 and 0,2 x 10(9)/l, respectively. Although interferon was successful in controlling the lymphoma the clinical course was complicated by the rapid development of aggressive, fatal Kaposi's sarcoma shortly after cessation of interferon treatment. It is suggested that the immunosuppressive effect of interferon therapy (or the T-cell lymphoma or both) may have played a role in the development of Kaposi's sarcoma as a second malignancy.

Female↗